A digest of events, trends, issues, ideas and journalism from and about rural America, by the Institute for Rural Journalism and Community Issues, based at the University of Kentucky.
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Friday, December 13, 2013

For several years farmland prices have continued to hit record levels, especially in the Corn Belt, leading to the fear of a bubble that could burst. With corn and other crop prices falling, experts say land values are likely to fall, even though farmland prices in places such as Iowa keep rising or holding steady. (Agriculture.com photo)

The Iowa Land Value Survey said Wednesday that "Iowa farmland's worth an estimated $8,716/acre, a 5.1 percent increase over the same time a year ago," Jeff Caldwell reports for Agriculture.com. "Northwest Iowa saw the highest values, with Scott County hitting a $12,413/acre average price, more than 12 percent higher than a year ago, the highest year-over-year climb in the state. But, Scott County's in an area that, though containing some of the state's highest-value land, has already seen a slight decline from a year ago, according to Iowa State University Extension farm management economist Mike Duffy, who conducts the biannual survey of land values." Duffy said record-high county land values is likely sign of a plateau.

"Iowa corn and soybean price movements are good
indicators of gross farm income movement," Duffy's report says. "There was a 33 percent drop in the
Iowa average corn price from October 2012 to October 2013 and there was
an 11 percent drop in soybean prices over the same time period. The November
estimated price for Iowa corn was 39 percent lower than the November 2012
price. Soybean prices were 11 percent lower. The
odds are against a major collapse in land values. But, if projections of
a new lower level for commodity prices hold, we should expect land
values to drop."

Steve
Bruere, president and owner of Peoples Co., a farmland brokerage based in Clive, Iowa, told Caldwell, "With the pullback in commodity prices, balance sheets are going to
take a hit. Not only is the grain in the bin worth less, but the value of
the farmland is directly correlated to commodity prices. If corn stays in the $4 [per bushel] neighborhood,
it’s going to be challenging to maintain current rental rates, as bankers
will start to pull in the reins on financing aggressive rents.
Ultimately, this means lower land values." (Read more) (Iowa State University graphic; click on it for larger image)

Rural cancer patients in Vermont are 66 percent more likely to retire at an earlier age than their urban counterparts after receiving treatment, and are 33 percent less likely to go on paid disability during treatment, finds a study by the University of Vermont published in the Journal of Cancer Survivorship. The study was conducted exclusively in Vermont, with the information based on 1,555 cancer survivors in the state.

"This disparity is ascribed to the fact that rural populations tend to engage in more physically demanding jobs," says a news release from Springer, which publishes the magazine. "The types of manual labor available in rural areas rarely offer
disability benefits, and therefore increase the impact of cancer
diagnosis for this population. According to the Department of Labor,
only 33 percent of persons employed in manual labor jobs are offered short-term
disability and only 21 percent are offered long-term disability as part
of their benefits. In contrast, more than half of all management or
professional workers are offered some form of disability."

Lead author Michelle Snowdwn wrote: “Providers who care for rural patients must recognize that these
patients may be at an increased risk for financial impact. Cancer care
for these patients should incorporate counselling services related to
returning to work after active treatment and assistance related to
disability. It is possible that survivorship programs
could lead this charge, with employment counseling becoming a standard
part of this post-treatment phase of care.” (Read more)

While the oil and gas boom in the West has boosted jobs in rural counties, the long-term impact of natural gas and oil production may be negative, decreasing per capita income, raising crime rates and lowering the share of adults with college educations, according to a study by Headwaters Economics, a research group that does such work in resource-extraction areas and has been skeptical of energy development.

Researchers reviewed data from 1980 to 2011, focusing on Colorado, Montana, New Mexico, North Dakota, Utah, and Wyoming, which produce "more than 75 percent of crude oil and more than 95 percent of natural gas in the contiguous West," according to the study. Researchers looked at the boom period from 1980 to 1982 "because it contained the highest share of personal income from oil and
gas for each of the six major oil- and gas-producing states in the U.S," and compared those counties changes in per capita income, crime, and education in 1980-2011. (Headwaters Economics graphic: Durations of above-average oil and gas income, 1980-2011)

In counties that got more than 8 percent of their personal income from oil or gas in the 1980-82 boom and specialized in the field for more than 10 years, compared to similar counties with
only one year of specialization, per capita income decreased by as much as $7,000 and the percentage of adults with a college education decreased as much as 2.5 percent. "These findings are consistent with other research that shows diminished socioeconomic benefit of resource extraction at the local level over time," the researches wrote. "The findings also support the theory that a resource curse has affected local areas that are specialized in oil and gas in the six energy-producing states in the U.S. West." (Read more)

A measure to ban hydraulic fracturing for five years in the Denver suburb of Broomfield initially fell 13 votes short last month, but a recount last week revealed that it had actually passed by 20 votes, making Broomfield the fourth Colorado town to pass a fracking ban in the November elections. But then a district court judge "issued an order barring
Broomfield from certifying the election results and ordered elections
officials to comply with state elections law," in response to a lawsuit filed by pro-fracking group Broomfield Balanced Energy Coalition, Megan Quinn reports for the Broomfield Enterprise. (Enterprise photo by David Jennings: A Broomfield resident collects signatures in July to get the anti-fracking bill on the ballot)

In a statement issued
Wednesday, the BBEC "said the group has repeatedly
asked Broomfield for 'basic election information that our designated
election watchers are entitled to review under state law,' including
vote logs and access to what election workers talked about during
alleged closed-door sessions," Quinn writes. The group said they were denied the information, and that “instead of jamming incomplete results
through the … certification process, city election officials should have
complied with our information request and engaged in an open process to
fix what was broken, before declaring the vote count as final."

City and County Attorney Bill Tuthill said Broomfield has given election watchers fair access to the election, Quinn writes."Because Broomfield has
already certified the election results, Tuthill likened the order to
ordering a gay couple not to attend a prom that already happened a week
ago." Tuthill told Quinn, "At some point in time, you have to say the election is over." The town plans to file a motion with the judge to reconsider. (Read more)

The "sequester," an $85 billion dollar budget cut now being amended, was supposed to equally affect a broad range of federal programs, but instead, those with stored-up cash or friends in high places avoided the reductions, while other groups suffered greatly, David. A. Fahrenthold writes for The Washington Post, and uses a Kentucky Head Start student and program as an example.

Prompted after a special "supercommittee" and the rest of Congress couldn't decide on a better plan to reduce federal deficit, the sequestration was automatically reduced spending across the board. At Head Start, "officials had to eliminate services for 57,000 children," Fahrenthold reports.

Carli Hopkins, 4, rests on mother Rebecca's shoulder as she
they enjoy a story. Carli was kicked out of Head Start by
budget cuts. (Washington Post photo by Luke Sharrett)

The sequester's ground rules were supposed to protect some programs—especially those that assist low-income families—from the cuts. Somehow, Head Start didn't make the list. Richard Koan, a budget expert who worked in the Obama administration, said the list didn't seem to matter because congressional leaders didn't think they would allow the sequester to happen.

Although some organizations lobbied for exemption—and in some cases, it worked—Head Start didn't. "There is a lot of goodwill about Head Start," said Yasmina Vinci, executive director of the National Head Start Association. "And I imagine if we had just chosen to say, 'Just us! Us! Us! Us!' we might have been able to get some action." The group didn't think that was right. "We have to have a complete approach," Vinci told Fahrenthold, "because Head Start works with the whole child and the whole family." As a result of the cuts, Head Start had to cut $401 million of their federal funding for fiscal 2013.

"Congress didn't make the hard choices. . . . They avoided the hard choices at all costs," said Peggy Grant, director of a Head Start program based in Owensboro, Ky., that covers 16 mostly rural counties. "And we had to make the hard choices, again and again." They had to cut $856,232 from the budget, and budget rules didn't allow her to store money from past years, so "164 children would have to be kicked out in the middle of the school year," Farenthold writes.

Yesterday the House passed a plan to replace about $45 billion of the sequester cuts with something less pervasive. "The plan is to let House and Senate appropriators choose specific trims, saving the muscle and cutting the fat," Fahrenthold writes. (Read more) CNNreports that "top aides" for the Republican minority "said they expect the budget to pass the Senate but
it could be by a razor thin margin. This could also change if momentum
against the bill grows."

Thursday, December 12, 2013

In an example of good enterprise reporting, Cristina Janney, managing editor of the daily McPherson Sentinel in the town of 13,000 in central Kansas, spent four weeks researching and writing about federal health reform's effect on rural hospitals as part of a project with the paper's owner, GateHouse Media. (Janney photo: Marcy Hospital in Moundridge has kept obstetrics although it makes no money from it. Many other rural hospitals have eliminated the department.)

Cristina Janney

In an extensive story, Janney explains how the law works, and how it affects rural hospitals, many of whom are already struggling financially, and could be hurt even further through the act, especially in a state like Kansas, which chose not to expand Medicaid. "Rural hospitals rely on Medicare payments – which primarily cover older people – for almost 45 percent of their annual income," she writes. " "Hospital administrators say they will have to change services and staffing to become more efficient and put more resources into primary care to reduce unnecessary hospital admissions.
Administrators also say the changes will be difficult at a time when rural hospitals already face tough economics. Rural hospitals work on a much smaller scale than their urban counterparts and so have a history of operating on small margins." (Read more)

Janney did a Q-and-A story with basic facts about the Patient Protection and Affordable Care Act, and wrote rural stories on a national level, about the struggles of Perry Memorial Hospital in Illinois and Barton Memorial Hospital in South Lake Tahoe, Calif., and how the hospitals are trying to cope with changes. Both states expanded Medicaid.

"Perry Memorial Hospital will close its obstetrics unit at the end of the year after 93 years of delivering babies," Janney writes. "The
small Princeton, Ill., hospital lost $500,000 on its obstetrics program
last year. Under the Affordable Care Act’s new payment rules for
Medicare, which primarily covers people over 65, and previous federal
budget cuts under sequestration, the hospital is also facing $1 million
in federal cuts." The hospital averaged 380 deliveries a year 15 years ago, but now averages 100 per year. The nearest hospital with an obstetrics department is 25 miles away. (Read more)

The California hospital is concerned about re-admissions, "one of the measures that will be tracked and tied to payments" with hospitals facing fines "as high as 3 percent of hospitals’ billings by fiscal year 2015," Janney writes. The hospital has trained four registered nurses as health coaches to make home visits to "review the patient’s case and care, including background on the illness and medications, and to answer any questions. The health coach also helps to arrange any follow-up visits with a primary care provider or specialists, and checks back by telephone on day 2, 4, 7, 14 and 30 after discharge." (Read more)

Want to know what the weather will be like in your county in the year 2100? The U.S. Geological Survey and the
College of Earth, Oceanic and Atmospheric Sciences at Oregon State
University introduced an interactive tool Wednesday that predicts temperature and precipitation changes in U.S. states and counties through the rest of the century, broken up into 25-year periods, comparing 1980-2004 to 2025-49, 2050-74 and 2075-99.

"By merging some 33 different climate models and using new NASA
techniques to make them accurate at smaller geographic scales, USGS
scientists said they could offer the county by county projections across
the the United States for the first time," James Bruggers reports for The Courier-Journal in Louisville. "They said they hope that
state and local officials and businesses will use the tool to help with adaptation planning."

Matthew Larsen, associate director for the USGS Climate and Land Use Program, said in a press release: "This product is innovative, user-friendly and invaluable for assessing
and understanding climate model simulations of local and regional
climate and climate change whether you’re a policy maker, a manager, a
planner, an educator or another engaged U.S. citizen. The maps and summaries at the county level condense a huge
volume of data into formats that are informative for planning, teaching,
adaptation and mitigation purposes." (Read more) To access the tool click here. Maps show how much the average temperature and precipitation are expected to change in each county; here's the national temperature map.

Saturday will mark the one-year anniversary of the school shootings in Newtown, Conn., that left 26 people dead, 20 of them children. While the event horrified the nation, it hasn't prompted many changes in gun laws. A measure for added background checks on Internet and gun show sales was unsuccessful in the U.S. Senate. Colorado passed stricter laws, but two state senators who voted for the bill were defeated in recall elections, and a legislator who supported background checks resigned in the face of a recall threat.

Why is it so hard to pass even a simple gun-control measure, such as added background checks? Robert Draper, a contributing writer for The New York Times, who authored a chronicle of the George W. Bush administration, writes that the answer lies in the enormous, partly unrecognized power of the National Rifle Association. He writes that that power was born out of calls for stricter gun laws after the 1968 assassinations of the Rev. Dr. Martin Luther King Jr. and Sen. Robert F. Kennedy.

"The 1968 Gun Control Act imposed a licensing system for purchases,
mandated serial numbers on weapons, banned certain gun imports and
barred felons and illicit drug users from obtaining firearms. Gun-loving
legislators like Rep. John Dingell of Michigan worried that
even harsher restrictions were imminent, and clamored for the NRA to
wake up and enter the political arena," Draper writes. "The lobbying arm, the Institute
for Legislative Action, was formed in 1975. Two years later, at a
now-famous annual convention in Cincinnati, [Democrat] Dingell and other NRA allies ousted the group’s reigning executives, who saw the organization
largely as a haven for gentleman hunters, and replaced them with
fire-breathing Second Amendment absolutists. The new lobbying director,
Harlon Carter, then led an energetic campaign to boost membership," and now the group claims 5 million members.

"The NRA scored its first major victory when Dingell and other friends
on the Hill succeeded in passing the Firearm Owners’ Protection Act of
1986, which restored many of the gun rights that were outlawed by the
1968 law," Draper writes. When President Bill Clinton and Congress passed a ban on assault
weapons [in 1994] the NRA "targeted the bill’s proponents during the
midterm elections. Many of them lost and Republicans became the
majority." When Clinton pushed for universal background checks after the 1999 Columbine shootings, the NRA killed the bill. "By the time the Virginia Tech murders occurred in 2007, it was
a fact of life in Washington: Any major legislation that the NRA
opposed stood little to no chance of passage."

Even after the faces of 20 six- and seven-year-old children gunned down in Newtown became regular fixtures in newspapers, the nightly news and the Internet, the NRA remained on the offensive. "Aware that the struggle would be fierce and expensive, the group offered discounts on annual and
lifetime memberships," Draper writes. "In the six months after Newtown, as gun-control
advocates pushed for legislation, the NRA was able to recruit more
than a million new members, Andrew Arulanandam, an NRA spokesman,
said."

And the NRA is willing to align itself with anyone it has to if it means getting what it wants, Draper writes. David Keene, former NRA president, told Draper: “Our effectiveness is
totally dependent on the fact that we reward our friends, and we stand
with them. Our goal isn’t to elect Republicans. It’s to support people
who support the Second Amendment.” (Read more)

"Ag-gag" is the term critics apply to state laws designed to prevent surreptitious recording of activities involving animal agriculture. Utah's law contradicts First Amendment rights and interferes with protection of U.S. food sources, 16 journalism organizations argued in a brief filed in federal court in Salt Lake City.

"The controversial law says, 'A person is guilty of agricultural operation interference if the person records an image of, or sound from, an agricultural operation under certain circumstances, obtains access to an agricultural operation under false pretenses, or obtains employment at an agricultural operation under certain circumstances with the intent to record an image of, or sound from, the agricultural operation'," Troy Wilde reports for Public News Service. Gregg Leslie, legal-defense director for the Reporters Committee for Freedom of the Press, told Wilde that the law makes it nearly impossible to expose possible cruelty and abuse. "It also affects journalists when the people who want to act as their sources when their conduct is criminalized," he said. "People have a right to know how food is handled, how animals are treated in slaughterhouses and in any other kind of facility."The brief argues, "Journalists and organizations that conduct investigations into meat-processing facilities have long been credited with advancing the safety of the meat the public consumes. Federal inspection has drastically improved the safety of the meat in the past century, but problems within the inspection system leave a gap in food safety that journalists and animal rights organizations have filled. While no journalist has the right to trespass on private property, the overbreadth of the Utah statue poses a substantial risk of criminalizing lawful—and constitutionally protected—newsgathering activity," according to a news release from the Reporters Committee.The plaintiffs for the case are the People for the Ethical Treatment of Animals (PETA) and the Animal Legal Defense Fund.

It could soon be easier, and cheaper, for journalists, film crews, and filmmakers to film on public lands. A House bill would charge an annual fee of $200 for camera crews of five or fewer people, amending rules set by the Agriculture and Interior secretaries, reports Agri-Pulse, a Washington newsletter. Yellowstone National Park charges crews of three to 10 people $150 per day. Other parks charge similar fees.

The bill would prohibits the agencies "from
assessing any additional fee for commercial filming activities and
similar projects that occur in those areas during those hours," according to the bill's language. It would also bar them "from prohibiting, as a motorized vehicle or under any
other purposes, the use of cameras or related equipment used for
commercial filming activities or similar projects in accordance with
this Act on federal lands and waterways administered by the Secretary."

Rep. Robert Latta (R-Ohio), who introduced the bill, testified in August before a subcommittee that the current laws “place a severe burden on individual journalists and small film crews. This bill is needed to ensure that public lands are open to being filmed for enjoyment by all Americans. In some instances, small crews, such as a cameraman following an elk hunter in a national forest, [are] being treated the same as a major Hollywood production with exorbitant fees and regulations.”

A Congressional Budget Office "score released last week, however, indicates the legislation might not do as much heavy lifting as the Ohio congressman indicated," Agri-Pulse reports. CBO said it "expects that, under the bill, certain film crews would pay less than the amounts required under current law and others would pay more." Agri-Pulse is subscription only, but can be accessed by clicking here.

Wednesday, December 11, 2013

In Belzoni, Miss., the disagreements over the Farm Bill—any version of which would cut food stamps and change farm subsidies—match those in Washington but are about real lives, not government policy. "Since 1995, farms in Humphreys County [Wikipedia map] have received about $250 million in subsidies [and] nearly half of the county's 9,100 residents receive food stamps, one of the highest rates in the nation," Ron Nixon writes for The New York Times.

These facts draw a clear line between those who fear cuts in food stamps and those who could receive more subsidies. Both the Senate and House versions of the bill would eliminate direct payments but expand crop insurance by $10 billion a year, while the House version would take 5 million people off food stamps, according to the Center on Budget and Policy Priorities, Nixon writes.

No one is sure how these changes will affects Humphreys County residents, but state officials are concerned. "Anything that reduces the program further will have an impact and could result in families' going without the benefits that get them over the hump every month, particularly in a country like Humphreys," said David Nobel, the state operations director at the state Department of Human Services, which administers the food-stamp program, officially the Supplemental Nutrition Assistance program.

Nixon lays out the farm subsidies: "Under the existing program, farmers can buy insurance that covers poor yields, declines in prices or both, allowing them to guarantee about 85 percent of their income," but the new bill would "guarantee about 90 percent of their income." Thomas Bond, a cotton grower whose onetime 8,500-acre partnership of farms has received $4 million in federal subsidies in the last seven years, said, "Farming is risky business. Farmers need a safety net." Some groups, such as the liberal Environmental Working Group and the conservative Heritage Foundation, have criticized the crop-insurance program, saying it mainly benefits insurance companies and well-to-do farmers.

All arguments aside, Bond wants Congress to pass the bill because without it, farmers find it difficult to plan for the future. "There's a lot of uncertainty, and that's not good when you're a farmer," he said. "Banks are reluctant to loan us anything when they don't know how they are going to get their money back." Uncertainly works both ways. Monica Stokes, a clerk at a local store, was cut off from $167 per month in food stamps because her income rose slightly. "People are uncertain about where their next meal might come from," she said. (Read more)

The U.S. Food and Drug Administration introduced a plan Wednesday that it hopes will help livestock producers "phase out the use of medically important
antimicrobials in food animals for food-production purposes, such as to enhance growth or improve feed
efficiency," the agency said in a news release. "The plan would also phase in veterinary oversight of the
remaining appropriate therapeutic uses of such drugs." The move is prompted by research showing that overuse of antibiotics creates resistance to the drugs, which is believed to be partly responsible for 23,000 humans dying each year from antibiotic-resistant infections. (New York Times photo by Brian Frank: Hogs in a confined feeding house)

The FDA released a report in
April saying 81 percent of all the raw ground turkey the agency tested
was contaminated with antibiotic-resistant bacteria, Jacque Wilson and Jen Christensen report for CNN. It also found that 69 percent of pork chops, 55 percent of ground beef, and 39 percent of chicken were contaminated. Citing the Pew Charitable Trusts, the reporters note that about 80 percent of antibiotics by weight in 2011 were sold for meat and poultry production, not human use.

Under the FDA plan, therapeutic uses of antibiotics in animals would require veterinary
oversight, meaning the drugs "could be used in food-producing animals
only under veterinary orders to treat, prevent or control disease," CNN reports. "Currently, the law tracks only how many antibiotics are sold; it does
not mandate data collection on how many animals are given the drugs or
how much. Without that information, it is hard to know where antibiotics
are used."

The FDA "will ask the drugs’ manufacturers to change labels to rule
out using the medicines to make animals grow," Sabrina Tavernise reports for The New York Times. "The changes are voluntary
for drug companies, but FDA officials said they believed the
companies would comply. Companies will have three months to tell the
agency whether they will change the labels, and three years to carry out
the new rules." Michael Taylor, the FDA's deputy commissioner for foods and veterinary medicine, told Tavernise, “Based on our outreach, we have every reason to believe that animal pharmaceutical companies will support us in this effort.” (Read more)

The FDA states: "The plan also calls for changing the current
over-the-counter status to bring the remaining appropriate
therapeutic uses under veterinary oversight. Once a manufacturer
voluntarily makes these changes, its medically important antimicrobial
drugs can no longer be used for production purposes, and their use to
treat, control, or prevent disease in animals will require veterinary
oversight." The proposed rule is open for public comment for 90 days, beginning Thursday. (Read more)

UPDATE, Dec. 12: "Some lawmakers and consumer advocates contend the agency should have
made the changes mandatory," The Wall Street Journal reports. "Rep. Louise M. Slaughter (D.-N.Y.) called
the guidance an 'inadequate response' that falls 'woefully short.' Jeff
Duchin, chairman of the Infectious Diseases Society of America's public
health committee, said the FDA action 'allows a lot of wiggle room, and
we'd like to see them move more quickly.' . . . The FDA's guidance urges drug makers to change drug labels to
allow the medicines' use only when medically necessary for livestock." (Read more) And one has to wonder if the industry will do that when animals consume 80 percent of U.S. antibiotics.

Looking for a way to localize the budget deal announced by congressional negotiators last night? Call up your local hospital.

David Rogers of Politico reports that hospitals are "furious with the fact that the deal offers no
relief from future cuts on Medicare providers – and even extends these
annual 2 percent reductions into 2022 and 2023." The cuts would be a continuation of those imposed by the "sequester" legislation that took effect when Congress failed to reach an anticipated deal on the federal deficit and taxes.

The $28 billion extension of the cuts, almost a third of the $85 billion total, "helps to dress up the package with tens of billions in savings, but at a time when hospital networks are already feeling the impact of health-care reform, there is a fear that Congress is not seeing the long term impact of these budget assumptions," Rogers writes.

Most rural hospitals are already facing Medicare cuts because reform law reduces the extra payments made to hospitals that have large percentages of Medicare patients. Those hospitals are disproportionately rural.

The deal also includes "a provision that aims to prevent fraud and abuse in the Medicaid program for the poor and disabled," Modern Healthcarereports. "According
to a summary, the provision allows states to delay paying for suspect
claims as long as the delay does not harm a beneficiary's access to
care. It also would allow states to collect medical child support in
cases where health insurance is available from a non-custodial parent
and allows Medicaid to recoup costs from beneficiary-liability
settlements."

Why cut Medicare payments? "Congressional staffers were not prepared to talk about the cuts on the
record, but said it boiled down to Medicare providers being the
least painful target. Democrats, they noted, have not traditionally been
strong supporters of preserving the payments to providers, being much
more concerned with maintaining funds for beneficiaries. Republicans saw
extending for two years cuts that are already in the law for mandatory
programs as a simple way to add deficit reduction to the replacement of
sequestration for discretionary programs," Michael McAuliff reports on The Huffington Post.

Is it safe to eat at the restaurants in your town? According to a study by the federal Centers for Disease Control and Prevention, the answer is a resounding "No." The study asked managers of several hundred restaurants in nine states about "storage and preparation of ground beef, chicken and leafy greens and the hygiene practices of food workers," Kathryn Roethel reports for the San Francisco Chronicle. "About 48 million people a year in the United States come down with
food-borne illnesses, and more than half of those illnesses can be
traced to food from restaurants, delis, banquet halls and schools," according to the report. (Chronicle photo by Penni Gladstone)

The study found that 80 percent of restaurants don't test ground meat with a thermometer to see if it's properly cooked, and more than 50 percent don't test chicken, Roethel writes. Sixty-two percent of workers don't wash their hands after handling raw meat, 40 percent of restaurants don't designate a specific cutting board for raw chicken, and 20 percent of workers said they worked a shift in the past year when they were sick with vomiting or diarrhea.

On the positive side, it's much safer to order a salad in a restaurant, with 93 percent of restaurants keeping "purchasing records so they could trace
where their greens came from in case of an illness-related recall, and
65 percent reported rejecting shipments if greens looked decomposed," Roethel writes. "However, a majority of greens delivered to restaurants came in at
temperatures above the proper 41 degrees Fahrenheit."

The study found that chain restaurants performed better than independent restaurants, Roethel writes. (Read more) To read the full report click here. Sounds to us like a good reason to run restaurant-inspection reports in the newspaper; more than a third of U.S. meals are obtained outside the home.

The Environmental Protection Agency has sent a draft rule to the White House's Office of Management and Budget, proposing to re-define what "qualifies as a body of water for federal protection under the Clean Water Act," a move that "could spread the EPA’s jurisdiction over agricultural waters wider than ever," reports Agri-Pulse, a Washington newsletter. "While the draft rule isn’t set to be officially released before the end of the month, leaked reports on its contents and the administration’s previous actions on the definition are igniting questions about potential changes for waters on agricultural land."

Several groups have weighed in on the issue, but no two seem to agree on what waters should fall under the EPA's jurisdiction, which has been a contentious issue since a 2006 Supreme Court case that resulted in a split opinion on the reach of EPA’s regulatory authority,
specifically on whether a wetland or tributary is a 'water of the United
States,'" Agri-Pulse reports. "The justices wrote five separate opinions, with none commanding a majority of the court. Justice Anthony Kennedy, in his opinion, wrote that wetlands are waters of the United States 'if they significantly affect the chemical, physical and biological integrity of other covered waters more readily understood as navigable.’"

Don Parrish, regulatory director for the U.S. Farm Bureau Federation, "says the administration is morphing Kennedy’s opinion into 'any connection'," which he said is not justified, Agri-Pulse writes. The draft rule could be based on an EPA report that states: "Streams, regardless of their size or how frequently they flow, are
connected to and have important effects on downstream waters. These
streams supply most of the water in rivers, transport sediment and
organic matter, provide habitat for many species, and take up or change
nutrients that could otherwise impair downstream waters. Wetlands and open-waters in floodplains of streams and rivers and
in riparian areas (transition areas between terrestrial and aquatic
ecosystems) are integrated with streams and rivers. They strongly
influence downstream waters by affecting the flow of water, trapping
and reducing nonpoint source pollution, and exchanging biological
species. Finally, there is insufficient information to generalize about
wetlands and open-waters located outside of riparian areas and
floodplains and their connectivity to downstream waters."

Along those lines, "The Teddy Roosevelt Conservation Partnership, which represents outdoorsmen and the conservation community, has its own agenda for the definition: It would like to see more protection for wetlands . . . than is now implied by EPA. Jimmy Hague, the director of the TRCP Center for Water Resources, said the organization wants 'unidirectional' waters, such as the wetlands of the Prairie Pothole Region in the northern Great Plains, protected under the rule, as well as the 'bidirectional' waters and 'adjacent water bodies' highlighted in the report." Agri-Pulse is subscription only, but can be accessed by clicking here.

Vice President Joe Biden on Tuesday announced $100 million in federal funds will be used to expand community-based mental-health services and treatment centers, with half the money going to rural clinics, Scott Wilson reports for The Washington Post. Biden, a strong supporter of gun control, made the announcement less than a week before the one-year anniversary of the school shootings in Newtown, Conn. that left 26 people dead, including 20 children. The shooter, who killed himself, was suspected to have had mental problems.

At the same time Biden made his announcement, Virginia Republican Gov. Bob McDonnell presented a two-year budget that includes $38.3 million in "reforms and funding boosts for mental health and substance-abuse
disorder programs," Olympia Meola reports for the Richmond Times-Dispatch. Last month, state Sen. Creigh Deeds, who lost the 2009 election to McDonnell, survived being stabbed by his son, who then killed himself. The day before the attack the son "underwent a psychiatric evaluation but was not admitted to a hospital, because no bed was available." Part of McDonnell's proposal allows "magistrates to grant a
two-hour extension to an emergency custody order – currently a max of
six hours -- if needed to find bed space. He would also extend temporary
detention orders to 72 hours, and expand crisis intervention team assessment centers." (Read more)

Biden's announcement includes "$50 million in new funding for community health centers looking to
expand treatment for people diagnosed with mental health and addiction
problems," with the money coming through the Affordable Care Act, Wilson writes. The U.S. Department of Agriculture "will also make $50 million in loans available
to rural clinics looking to expand facilities, a way of alleviating a
shortage of mental health care outside urban areas." (Read more)

A news release from the USDA states: "The funding will be used for the construction, expansion, or equipping
of rural mental health facilities and will be provided through the
Community Facilities direct loan program... This year, USDA invested more than $649 million in 130 rural health care
facilities – serving nearly 3.2 million rural residents. These
investments included critical access hospitals, rural health clinics,
psychiatric hospitals, mental health care facilities, group homes for
people with disabilities, assisted living facilities, nursing homes, and
vocation and medical rehabilitation facilities. USDA is also investing
in innovative healthcare technologies such as telemedicine, to further
expand access to health care services throughout rural America." (Read more) (NBC News clip)

Non-violent criminals in remote areas of Georgia now have an opportunity to avoid jail time and enter a program to help them get their lives back on track. The state Department of Corrections already offered "intensive drug counseling and
other services designed to keep probationers from reoffending," at 14 regional day-reporting centers in urban areas, but now rural offenders are getting the same opportunities to get a second chance with the opening of 11 rural centers, Adam Ragusea reports for Georgia Public Broadcasting. The program also saves the state money, with the cost of incarcerating prisoners amounting to more than $50 a day. (Ragusea photo: Probation Officer Christopher Burke talks to probationer Chet Mull, who is working on his GED)

House Bill 349, signed in April, "restores judicial discretion by allowing a departure from
mandatory minimum sentences in some very limited circumstances," John Barker reports for Douglasville Patch, about 22 miles west of Atlanta. "As a
result, judges now have the option to make more appropriate decisions
in drug-related cases where the defendant is not the ringleader of the
criminal enterprise, or in other cases where the prosecution, defense
attorney and judge agree." Republican Gov. Nathan Deal said of the bill: “Public safety will be improved by giving
prosecutors leverage in certain cases and by ensuring that our prison
resources are reserved for the ‘kingpins’ while the ‘mules’ are given a
chance at reform.”

The program, which costs $750,000 a year, allows participants to spend four days a week in group counseling, and allows officers to give individual extra attention, Ragusea writes. Ruthie Turner, a program counselor, told him, “We teach a class that helps them get ready to make a
change in their lives,” by offering substance abuse
programs and skills that help probationers re-enter society — “how
to do a résumé, how to do a job interview, how to dress for those
things." And the program has been a big success, Ragusea writes. "Of the 60 probationers who have graduated the DRC Lite program so far,
corrections officials said, only three have gotten into serious trouble
with the law again." To read more, or listen to the radio interview, click here.

Tuesday, December 10, 2013

UPDATE, Dec. 13: Congressional Budget Office scoring of the proposed compromise on farm subsidies "puts us in good shape," Senate Agriculture Committee Chair Debbie Stabenow told Rogers, who reports: "Friday’s upbeat tone signaled the focus is already shifting toward
preparing other members of the House-Senate conference for votes during
the week of Jan. 6."

UPDATE, Dec. 12: By voice vote, the House passed an extension that would run through January. "Critics contend it is a needless distraction from the task at hand," Rogers reports, "but
House Agriculture Committee Chairman Frank Lucas (R-Okla.) saw it as a
useful step to sooth frayed nerves while he tries to deliver a final
bill in early January."UPDATE, Dec. 11: Senate Majority Leader Harry Reid said the Senate would not consider another extension of current farm law. That means the law will revert to a 1949 statute that would jack up dairy price supports and double milk prices, but Stabenow said the Agriculture Department had assured her "that the price spikes would not happen before the end of January," writes Mary Clare Jalonick of The Associated Press.UPDATE: "Farm bill negotiators conceded Tuesday that they will not finish their
work before Congress goes home for the year, but insisted that they are
close to a final deal and working toward floor action in early January," Rogers reports.But they may forgo an extension to create pressure for a vote in early January.

A House vote to extend the current Farm Bill for a month or so could occur as early as tomorrow, with one negotiator saying lawmakers are near a deal that can be voted on in January, after the holiday recess that begins Friday. David Rogers reports for Politico, "Speaker John Boehner has already signaled he is open to this
option and a vote could come as early as Wednesday on the suspension
calendar," which would require a two-thirds vote.

This would be the second extension of the Farm Bill since it expired 15 months ago, Rogers writes. "But the circumstances now are very different. Last year at this time, the House had yet to even act on a farm bill
and a long-term extension was needed through this past September. The
legislative process is much farther along now—albeit still tortured. And
there is a genuine hope that a House-Senate conference can report a
Farm Bill back for final action in January." (Read more)

Rep. Collin Peterson, D-Minn., "one of four House and Senate negotiators
working behind the scenes on a compromise between the two chambers,
said the framework of a farm bill deal could be finished before the
House adjourns for the year on Friday," Kyle Potter reports for the Fargo Forum. "Peterson said the negotiators have agreed on how much to cut from food
stamps – one of the largest sticking points between the House and
Senate. Peterson declined to provide a number, but said the deal hews 'substantially closer to the Senate’s' targeted cuts of $4 billion over
the next decade rather than the House’s bill, which would slash $40
billion from the Supplemental Nutrition Assistance Program."

Peterson, the ranking Democrat on the House Agriculture Committee, told the Forum, "I think it will pass the Senate, but I cannot guarantee you it will pass
the House. They are not going to be happy with the food-stamp cuts.” Peterson said he is confident he can get 'yes' votes from at least half of House Democrats. (Read more)

As wildlife pouplations increase and populated areas expand, causing conflicts, hunting is on its way to making a major comeback, with some areas already legalizing hunting within towns and cities, David Von Drehle writes in a cover story for Time magazine's latest edition.

"Faced with an outbreak of lyme disease and rising deer-related car
accidents, the city council of Durham, N.C., authorized bow hunting
inside city limits in November. Authorities in San Jose, Calif., in the
heart of Silicon Valley, voted to allow hunting wild pigs within that
city in October. Rock Island, Ill., . . . recently approved bow hunting in town, provided that
it occurs in green spaces — golf courses, parks, cemeteries — or on
private land."

"We have too many wild animals — from swine to swans," Von Drehle writes. "Whether you're a
Walmart employee in Florida wondering what to do with the alligator at
your door, a New Yorker with a hawk nesting on your high-rise or an Ohio golfer scattering a flock of Canada geese, you now live, work and play in closer proximity to untamed fauna than any other generation of
Americans in more than a century."

"Too many deer, wild pigs, raccoons and beavers can be almost as
bad for the animals as too few," Von Drehle writes. "This is why communities across the
country find themselves forced to grapple with a conundrum. The same
environmental sensitivity that brought Bambi back from the brink over
the last century now makes it painfully controversial to do what experts
say must be done: a bunch of these critters need to be killed." Time is subscription only, but can be accessed by clicking here.

The argument over whether drilling has caused earthquakes in Oklahoma continues, as a state not typically known for seismic activity ranks second in the number of quakes since 2009. The increase in includes a rash of no less than 16 quakes one day in November in the Oklahoma City area.

"Since 2009, nearly one out of every 10 earthquakes in the contiguous United States has been in Oklahoma, according to an EnergyWire
analysis of U.S. Geological Survey data," Mike Soraghan reports for the news service. "The analysis looked at onshore
quakes of magnitude 3.0 or greater, the strength at which most
earthquakes can be felt and reliably recorded." Oklahoma has had 240 quakes since 2009, second to California's 1,486, but well ahead of Nevada, third with 196. (EnergyWire graphic)

"Other states have also seen an increase in earthquakes amid a boom in oil and gas production across the United States," driven by horizontal hydraulic fracrturing of deep, dense shale beds, Soraghan notes. "State officials and researchers have linked injection of drilling
waste to quakes in Arkansas, Colorado, Ohio and elsewhere. In Texas, a
recent series of quakes northwest of Fort Worth has some local elected
officials questioning whether deep injection of drilling waste might be
to blame. But for whatever reason, the phenomenon has been particularly acute in Oklahoma."

Residents affected by the quakes aren't holding back when it comes to assessing blame. Jonny Hickman, who lives about 1.5 miles from a well, told Soraghan, "Forty-five years I've lived on this hill. I never
felt anything until they started injecting that salt water." Neighbor Tony Bartee, who has a crack in his outside wall, told Soraghan, "You got a lot of big money sitting there,. That fracking is a big
deal. If they say for sure that's what's causing it, it's gonna cost
those boys a lot of money."

And that, some think, is the problem. Drilling brings in lots of money to the state, and not everyone is quick to point fingers at the practice. Mike Terry, president of the Oklahoma Independent Petroleum Association, told Soraghan, "There are still many unknowns and uncertainties in regards to seismic
activity in central Oklahoma. Researchers in Oklahoma, notably Austin Holland with the Oklahoma
Geological Survey, have repeatedly said the increase in seismic activity
cannot be fully explained by man-made causes." (Read more)

In the midst of the debate about the environemntal impact of the natural-gas boom, unions and environmentalists agree on something: old, leaky pipelines, which put both the environment and public health in jeopardy, need to be repaired. Methane, which is leaking from the pipes, is a powerful greenhouse gas and can be explosive in high concentrations. "The Department of Transportation estimates that more than 30,000 miles of decades-old, decaying cast-iron pipe are still being used to deliver gas nationwide," Kevin Begos writes for The Associated Press.

This agreement between trade unions and environmentalists is notable, especially after a year of struggling to find balance between a need for jobs and the need for fossil fuel pollution reduction. "Some trade unions have supported the drilling boom, while some environmentalists have pushed for bans on the hydraulic fracturing, or fracking, process," Begos writes. "To the extent we have a problem we can identify, it certainly makes sense to fix it," Delaware Riverkeeper Maya K. van Rossum wrote in an email. "I don't think that calling for the fix of existing leaky pipelines is contrary to a call for ending shale gas development or fracking."

In 2011, a cast-iron main installed 83 years before helped cause an explosion, killing five people and demolishing many homes in Allentown, Pa. No one is sure how much gas is leaking now, but old cast-iron pipe definitely poses a risk. Duke University scientist Rob Jackson, who has studied the issue, said fixing leaks "will save money and lives, improve air quality and health and slow climate change. What's not to like?"

"According to the Department of Transportation, New York City still uses about 3,000 miles of decades-old cast-iron pipe, Boston about 2,000 miles, Philadelphia about 1,500 miles and the District of Columbia 400 miles," Begos writes. "Experts say much of the old pipe dates to before World War II, and some of it may even be more than 100 years old." Last month U.S. Sen. Edward Markey, D-Mass., presented two bills about the pipeline repair, and a coalition of groups is backing them, but it's not yet certain how much support they have from Congress. (Read more)

Infants are dying in Kansas at a rate higher than the national average, with rates even higher among rural families, Kelsey Ryan reports for The Wichita Eagle. The state's infant mortality rate in 2012 was 6.3 deaths for every 1,000 children born, while the national average was 5.9 deaths for every 1,000 children born. In 2012, Kansas had 254 infant deaths, compared to 247 in 2011, an increase of 1.6 percent.

"The infant mortality rates in Kansas are higher for babies born to women
who live in rural and densely settled rural areas compared to infants
born to women who live in frontier (less than six people per square
mile), urban and semi-urban areas, according to state vital statistics data from 2008 to 2012," Ryan writes. Even though more infant deaths occur in urban areas, rural infant deaths really stand out in remote, low-population areas like Rawlins County, the dark green square in the northwest on the map below. The county of 2,500 leads the state in infant deaths, even though there were only three in the study period; its rate was 25 deaths for every 1,000 births. The three counties surrounding Rawlins County also have high rates, with each averaging more than 14 deaths for every 1,000 children born. (Eagle map from Kansas Department of Health and Environment data; for the interactive version click here)

Limited access to quality medical services, and lack of health insurance, are some of the reasons for the higher death rates in rural areas, Ryan writes. "Of the roughly 40,000 live births in Kansas last year, nearly 18 percent
of pregnant women received 'inadequate' or 'intermediate' prenatal
care, according to state data. Lower levels of care were more likely to occur in rural areas than in urban areas." Most of the counties rated "inadequate" are in the western part of the state, where poverty runs higher. The report also found that in 2012 more than 5,400 women smoked during pregnancy; local data are available on the interactive map.

"Statewide, more than 2,100 women who gave birth in 2012 didn’t seek
prenatal care until they were at least six months pregnant, according
to the KDHE report. More than 350 women never sought prenatal care
before birth," Ryan writes. One reason is the long distances required to travel to see a specialist. Christy Schunn, executive director of the Kansas Infant Deaths and
SIDS Network, told Ryan, “Access to health care seems to be a concern. I
talk to a lot of families who have had infants die, and they didn’t
have medical insurance and by the time they got insurance, they were
halfway through their pregnancy. We need early prenatal care.” (Read more)

Eastern Kentucky leaders trying to get the region's coal-based economy out of a depression seemed interested in ideas from the Iron Range in northeastern Minnesota, presented yesterday to a crowd of 1,500 people at an event in Pikeville convened by Kentucky's Democratic governor and the region's Republican congressman. Coverage from the Lexington Herald-Leader is here.

But as they considered the idea of setting aside part of the state's coal severance tax revenue in a trust fund, and using only the interest for current projects, as the Iron Range does, some wondered if the idea was too late, given the parlous fortunes of the Central Appalachian coal industry. "It probably should have been done 20 or 30 years ago," state Sen. Robin Webb, D-Grayson, told Lexington's WVLK-AM Tuesday.

Democratic Gov. Steve Beshear said at a news conference that the next state budget will be so tight, "we can't be fooling" with the current 50-50 split of severance-tax revenue between the state and the region, but he told Bill Goodman of Kentucky Educational Television that the idea of a regional economic planning fund like the one in Minnesota "ought to be on the table" for the future.

The conference moderator, Rural Policy Research Institute Director Charles Fluharty warned summit attendees were that they needed to get over rivalries among counties in Eastern Kentucky, where many counties are small. "These counties and towns are competitive," U.S. Rep. Hal Rogers, R-Somerset, told Goodman. "It's hard to weld together a regional organization because many of those counties have some animosities from 80 years ago."

Just before the conference began, former Gov. Paul Patton of Pikeville told The Rural Blog that the effort would require a continued commitment by Beshear, who must leave office in 2015, and Rogers, who must give up his House Appropriations Committee chairmanship at the end of 2016. "the congressman and I are committed to the long haul," Beshear said. "We're also committed to some big, broad issues." For coverage from Ronnie Ellis of Community Newspaper Holdings, which has 10 papers in Appalachian Kentucky, click here. For his severance-tax story, go here.

Monday, December 09, 2013

While the rate of homelessness in rural areas is about the same as in urban areas, urban homeless are often visible on the streets, while many rural homeless people are out of sight, living "in the woods, campgrounds, barns, vehicles or abandoned or substandard housing not truly meant for habitation," writes Sid Salter, a contributing columnist for the Clarion Ledger in Jackson, Miss.

The rural homeless problem is a real one, and hard to define precisely Salter writes: "Counting homeless people, like counting immigrants or others who are distrustful of authority figures, is an incredibly inexact science," and the counts by the U.S. Department of Housing and Urban Development are probably low. "Of the 2,403 Mississippi homeless identified by HUD . . . 501 are in emergency shelters, 582 are in some temporary traditional housing and 1,320 are 'unsheltered.' The worse news about homelessness in Mississippi is that it is exacerbated by poverty, and Mississippi remains the poorest state in the union."

Of Mississippi's 2,403 homeless, HUD classifies 475 "as 'chronically homeless.' Another 230 of our homeless are 'severely mentally ill.' Another 498 of the state’s homeless are listed as engaging in 'chronic substance abuse' while another 230 of them are veterans," Salter writes. "It seems the problem of homelessness is somehow more depressing and hopeless during the holiday season. That’s why many very noble efforts to provide holiday meals and toys for underprivileged children find success at this time of year.
But the truth is that poverty, homelessness, mental illness and substance abuse threaten Mississippi families all year long and require not merely the generosity of the holidays but a place at the table of public-policy debate." (Read more)

In the U.S., "There are approximately 14 homeless people on average for every 10,000
people in rural areas, compared with 29 homeless people out of every
10,000 in urban areas," according to the National Alliance to End Homelessness. "The same structural factors that contribute to urban homelessness—lack
of affordable housing and inadequate income—also lead to rural
homelessness. Perhaps the most distinguishing factor of rural
homelessness, however, is access to services. Unlike in urban areas,
many rural homeless assistance systems lack the infrastructure to
provide quick, comprehensive care to those experiencing homelessness.
Reasons for this difference abound, including lack of available
affordable housing, limited transportation methods and the tendency for
federal programs to focus on urban areas." (Read more) (American Almanac graphic: Rural homeless in shelters)

During the Great Recession, more students turned to community colleges to save money, and enrollment at those schools zoomed. But since the end of the recession, fewer students are enrolling in community colleges, and state funding has declined, putting the future of some of those institutions in jeopardy, according to J. Noah Brown, president and chief executive officer of the Association of Community College Trustees, Chris Parr reports for Times Higher Education.

Brown told Parr, "Where a
college may once have got 40 percent of its support from the state, it
may now be receiving 12 percent. About two-thirds of our community colleges are based primarily in rural
areas. These are very small colleges with 400 or 500 students. I’m worrying . . . about those institutions’ ability to survive
in a student market that may be declining, as well as a market where
we’d do well to stabilize public funding.”

Brown's "warning comes after a survey of state community college directors by
the University of Alabama at Tuscaloosa’s Education Policy Center found
that although many expect 'modest percentage increases in state
appropriations' next year, declining enrollment would mean 'less overall
tuition income,'” Parr writes. (Read more) For a list of every community college in the U.S. click here.

Senate Minority Leader Mitch McConnell said in a speech Saturday that looking back is the way to move forward to pass immigration reform, with the Kentucky Republican citing the Compromise of 1850 by Kentucky's Henry Clay and Illinois' Stephen Douglas as a lesson about how politicians can come to a compromise over heated issues, Ryan Alessi reports for cn|2, a service of Time Warner Cable.

Because senators couldn't come to an agreement on the compromise, which dealt with slavery and related issues, it was split into several pieces "in an attempt to seek a compromise and avert a crisis between North and South," according to the Library of Congress. McConnell said Congress needs to do the same thing to pass immigration reform, Alessi reports. "While the U.S. Senate passed a comprehensive measure earlier this year,
Republican House Speaker John Boehner said that bill won’t move in the
lower chamber in 2013." Others in the House have talked about passing separate bills.

McConnell told the Kentucky Farm Bureau Federation at its annual meeting, "In the House of Representatives, I think the way forward is to pass separate bills dealing with various issues." He said, "Congress needs to make changes to U.S. immigration laws, including to the H-2A guest worker visa program that is important to many farms that hire immigrant workers during planting and harvesting seasons." (Read more)

The Department of the Interior has finalized a new 30-year permit to allow wind farms and other projects—if they meet certain requirements—to accidentally kill federally protected eagles. The move "highlights a tension lingering between two key goals of the environmental movement: developing renewable energy sources and protecting wildlife," Alexandra Berzon writes for The Wall Street Journal.

Associated Press photo: A golden eagle avoids wind blades.

The wind industry will benefit from the new ruling, especially because many felt that the current five-year permit caused uncertainty because companies wanted to launch large-scale project that could take up to 30 years. To receive the longer permit, companies will be required to show they are trying to preserve eagles, according to the Fish and Wildlife Service, Berzon writes. "This isn't a free pass," said Peter Kelley, vice president of public affairs for the American Wind Energy Association, a trade group. "To get a permit you have to persuade the government you're going to do an extensive regime or offset [bird harm] by preserving habitat."

In the past several years, large birds have died from the impact of spinning blades of wind turbines. Fish and Wildlife spokesman Chris Tollefson said, "I think from a legal standpoint it is much easier to make a case against a company if you have a permitting process that hasn't been followed."

Although renewable energy sources like hydroelectric dams, solar arrays and other projects sometimes damage plants and animals, many environmentalists say renewables are still less injurious than fossil fuels. Even so, not everyone is in favor of the change. "This is going to lead to more dead eagles—plain and simple," said Mike Daulton, vice president of government relations for the National Audubon Society.

Executives say the new permit should encourage many companies to apply for permits so they won't be prosecuted. A Duke Energy spokeswoman said of the new ruling, "This provides some certainty and clarification to the industry." (Read more)

The Appalachian-based film "Out of the Furnace" debuted over the weekend to less than stellar box-office numbers. But the $22 million film's $5.3 million take wasn't bad, considering everyone involved probably has just one eye on the box office and the other on the upcoming awards season. Just about all the stars—Christian Bale, Forest Whitaker, Sam Shephard, Woody Harrellson, Willem Dafoe and Casey Affleck—has either won or been nominated for an Academy Award. (Rotten Tomatoes photo: Christian Bale in "Out of the Furnace")

The movie, which takes place in Pennsylvania, is another in the long line of films that doesn't paint Appalachia as the greatest place to live, with drugs and violence ruling the day. But the release of the movie got Jay Fernandez of Word and Film thinking about other movies and novels set in Appalachia. He discusses both how Hollywood has displayed Appalachia on the big screen and how novelists have painted the region in words. (Read more)

The federal health reform law continues to put pressure on rural health care systems. We reported on doctors in rural Vermont who are already at capacity and unable to accommodate new patients. The same problem is occurring in rural Virginia, especially in its Appalachian region, and may increase if tehe state expends the Medicaid program.

As more patients become insured through the law, more people are seeking
doctors, but there aren't enough doctors to treat the new patients. In Virginia "there’s a projected shortage of about 600
patient care physicians—a gap that is expected to grow to more than
2,500 full-time equivalent positions by 2030, according a 2010 forecast
by the Lewin Group for the Virginia Department of Health Professions," Laurence Hammack reports for The Roanoke Times.

Places like Highland County (Wikipedia map) have been especially hit hard, Hammack writes. The county of 2,200 people doesn't have a hospital or pharmacy and has been without a practicing physician since last December. The county does have a medical center that has 10,000 patient visits a year; nurse practitioners handle most of them. "In fact, the most frequent call to the Highland County Volunteer Rescue
Squad is made from the medical center, where the most seriously ill or
injured patients must be transported by ambulance or helicopter more
than 50 miles to hospitals in Augusta, Bath and Rockingham counties,
according to squad captain Chris Vernovai."

At least Highland County has a facility. In Lee County, at Virginia's western tip, the only hospital closed Oct. 1, Hammack notes. "Wellmont Health System, which ran the hospital, said the
closure was partly the result of cuts in Medicare reimbursements under
the Affordable Care Act." Beth O’Connor, executive director of the Virginia Rural Health Association, said "the hospital is the first in Virginia to close as a result of Medicare
payment reductions, according to O’Connor."

Some local doctors aren't buying that the hospital closed because of the reform law, Hammack reports. Dr. Art Van Zee "said Wellmont’s blaming of the Affordable Care Act is 'an invented, if not
spun, reason for the closure.' Van Zee said Wellmont shuttered the hospital with
the expectation that patients would go to other hospitals it runs in
neighboring counties, protecting its bottom line—if not the residents
of Lee County." Van Zee told Hammack, “Many lives are at risk, and some lives without question are going to be lost.” (Read more)

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This blog generally follows traditional journalistic standards. It's not about opinions, though you may read one here occasionally. It's about facts that we think will be useful to rural journalists, non-rural journalists who do rural stories, and others interested in rural issues. We don't try to be provocative, so we don't generate as many comments as most blogs with the level of traffic we have, but we certainly invite comments -- and contributions, to al.cross@uky.edu. Feel free to republish blog items, with credit to us and the original source.